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Americans Are Fat and Getting Fatter: The Depressing Details of the 2011 “F as in Fat” Report

Animation of U.S. Obesity Trends by State 1985...

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I spend a lot of time writing about topics like running shoes and running form here on Runblogger. Ultimately, though I enjoy the scientific debate involved when discussing research, as well as the fun I get to have when testing out new shoes, my primary motivator for writing this site is a simple desire that people run happy and without injury.

I am a strong believer in the health value of physical activity and exercise, and I developed an Exercise Physiology course at my College in order to better educate my students about the benefits of being active. At the end of each semester I finish that course with a series of lectures on exercise, obesity, and health. One of the reports that I reference in those lectures is the F as in Fat report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The report details obesity and health related trends in the United States, and the 2011 data have just been released. I wanted to share the press release here because I think it’s important, and the trends that we are seeing here in America are not good.

I encourage you to share this report widely, as those of us who have seen personal health transformations resulting from getting active are among the best advocates for lifestyle change. If you have a blog, tell your own story (I have shared my own story of transformation here), or go to the Trust for America’s Health website and copy and post the press release (you can find it here). Spread the word, be an advocate for activity and a healthier lifestyle, and be an example for your friends and family.

Without further adieu, here is the press release containing a summary of the results from F as in Fat 2011:

F as in Fat: How Obesity Threatens America’s Future 2011

Adult obesity rates increased in 16 states in the past year and did not decline in any state, according to F as in Fat: How Obesity Threatens Americas Future 2011, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).  Twelve states now have obesity rates above 30 percent. Four years ago, only one state was above 30 percent.

The obesity epidemic continues to be most dramatic in the South, which includes nine of the 10 states with the highest adult obesity rates. States in the Northeast and West tend to have lower rates. Mississippi maintained the highest adult obesity rate for the seventh year in a row, and Colorado has the lowest obesity rate and is the only state with a rate under 20 percent.

This year, for the first time, the report examined how the obesity epidemic has grown over the past two decades. Twenty years ago, no state had an obesity rate above 15 percent.  Today, more than two out of three states, 38 total, have obesity rates over 25 percent, and just one has a rate lower than 20 percent. Since 1995, when data was available for every state, obesity rates have doubled in seven states and increased by at least 90 percent in 10 others. Obesity rates have grown fastest in Oklahoma, Alabama, and Tennessee, and slowest in Washington, D.C., Colorado, and Connecticut.

“Today, the state with the lowest obesity rate would have had the highest rate in 1995,” said Jeff Levi, Ph.D., executive director of TFAH. “There was a clear tipping point in our national weight gain over the last twenty years, and we can’t afford to ignore the impact obesity has on our health and corresponding health care spending.”

Obesity has long been associated with other severe health problems, including diabetes and high blood pressure. New data in the report show how rates of both also have risen dramatically over the last two decades. Since 1995, diabetes rates have doubled in eight states. Then, only four states had diabetes rates above 6 percent.  Now, 43 states have diabetes rates over 7 percent, and 32 have rates above 8 percent. Twenty years ago, 37 states had hypertension rates over 20 percent. Now, every state is over 20 percent, with nine over 30 percent.

Racial and ethnic minority adults, and those with less education or who make less money, continue to have the highest overall obesity rates:

  • Adult obesity rates for Blacks topped 40 percent in 15 states, 35 percent in 35 states, and 30 percent in 42 states and D.C.
  • Rates of adult obesity among Latinos were above 35 percent in four states (Mississippi, North Dakota, South Carolina, and Texas) and at least 30 percent in 23 states.
  • Meanwhile, rates of adult obesity for Whites topped 30 percent in just four states (Kentucky, Mississippi, Tennessee, and West Virginia) and no state had a rate higher than 32.1 percent.
  • Nearly 33 percent of adults who did not graduate high school are obese, compared with 21.5 percent of those who graduated from college or technical college.

More than 33 percent of adults who earn less than $15,000 per year were obese, compared with 24.6 percent of those who earn at least $50,000 per year.

“The information in this report should spur us all – individuals and policymakers alike – to redouble our efforts to reverse this debilitating and costly epidemic,” said Risa Lavizzo-Mourey, M.D., M.B.A, RWJF president and CEO. “Changing policies is an important way to provide children and families with vital resources and opportunities to make healthier choices easier in their day-to-day lives.”

This year’s report also includes a series of recommendations from TFAH and RWJF on how policymakers and the food and beverage industry can help reverse the obesity epidemic.

The recommendations for policymakers include:

  1. Protect the Prevention and Public Health Fund:  TFAH and RWJF recommend that the fund not be cut, that a significant portion be used for obesity prevention, and that it not be used to offset or justify cuts to other Center for Disease Control and Prevention (CDC) programs.
  2. Implementing the Healthy, Hunger-Free Kids Act:  TFAH and RWJF recommend that the U.S. Department of Agriculture (USDA) issue a final rule as swiftly as possible regarding school meal regulations and issue strong standards for so-called “competitive” food and beverages – those sold outside of school meal programs, through à la carte lines, vending machines and school stores.
  3. Implementing the National Physical Activity Plan:  TFAH and RWJF recommend full implementation of the policies, programs, and initiatives outlined in the National Physical Activity Plan.  This includes a grassroots advocacy effort; a public education program; a national resource center; a policy development and research center; and dissemination of best practices.
  4. Restoring Cuts to Vital Programs:  TFAH and RWJF recommend that the $833 million in cuts made in the fiscal year 2011 continuing resolution be restored and that programs to improve nutrition in child care settings and nutrition assistance programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children be fully funded and carried out.  If fully funded these programs could have a major impact on reducing obesity.

“Creating healthy environments is key to reversing the obesity epidemic, particularly for children,” remarked Dr. Lavizzo-Mourey. “When children have safe places to walk, bike and play in their communities, they’re more likely to be active and less likely to be obese. It’s the same with healthy food: when communities have access to healthy affordable foods, families eat better.”

Additionally, for the food and beverage industry, TFAH and RWJF recommend that industry should adopt strong, consistent standards for food marketing similar to those proposed in April 2011 by the Interagency Working Group, composed of representatives from four federal agencies – the Federal Trade Commission, CDC, Food and Drug Administration and the USDA – and work to implement the other recommendations set forth in the 2005 Institute of Medicine report on food marketing to children and youth.

Report results for individual states can be found here (scroll to bottom of the page).

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About Peter Larson

This post was authored by Peter Larson. Pete is a biology teacher, track/soccer coach, and dad (x3) with a passion for running, soccer, and science. If you'd like to learn a little bit more about who I am and what I do, click here, or visit


  1. People need to have the mental strength to not get fat.  I hate to be frank, but the only way to lose weight is to create a calorie deficit.  If you exercise more, you will not lose weight if you eat more.  Fortunately, I can run because it is fun for me, not because I have to.  I suspect that most people who read this blog are on the extremely fit side of the spectrum.

    • Charles says:

      The best way to lose fat is to reduce insulin levels. Poor people are fatter because the cheapest foods are high in carbs which increases insulin levels.

    • Pete Larson says:

      Regular readers yes, but I get a majority of traffic via Google search, and lots of emails from folks just starting to run who are looking for shoes.

  2. George Lin says:

    I agree with the previous poster to a point.  I think people need to have the mental strength and desire not to get fat and (if necessary) slim down. That being said, I feel you need to be completely honest with yourself.  And that’s really not an easy thing to do.  It is way too easy to make excuses.  Furthermore you need to look at what you eat and how you eat.  Unfortunately it seems that in the US portion sizes are way too big.  This is especially true at food establishments.  That said, it can also be true for what you buy to eat at home.  It can be staggering to look at what 1 serving size is versus how much you actually consume.

    I run as a means for weight loss.  At my peak I was 165, which for my height 5’7″ is at the very peak of being overweight.  More importantly though it seemed that annually I was gaining at least 5 solid pounds a year and my waistline was growing.  Furthermore my cholesterol and blood pressure numbers were a mess.  To be quite honest, I made myself slim down because I didn’t want my doctor crowing at me to do it.  Now she pretty much has to say nothing, because she knows that I know how to lose weight.

    That said, I do agree that this is preaching to the choir, but it is an important message regardless of who it is being told to.

  3. I disagree with previous posters. There has been a dramatic change change in the American diet that coincides very closely to the obesity epidemic. To name a few – a dramatic increase in the consumption of grains, dramatic decrease in the consumption of specific types of fat, and the eating of more processed foods.

    America never had an obesity problem until the government started to recommend high grain low fat diets about 40 years ago to prevent heart disease. Unfortunately now we still have high rates of heart disease and we also have high rate of obesity. Those recommendations were based on very shoddy research, and had a lot of political overtones.

    Calories are not all the same, and the body reacts very differently to a calorie of fat, protein and carbohydrate. If you have to fight with your body to create a calorie deficit, then you are eating the wrong foods, and you are not getting enough nutrition.

    If you don’t want to get fat, eat natural foods, minimize the
    consumption of grains and sugar, make sure you balance the types of fat
    you are eating and get regular exercise.

    I am also speaking from personal experience. I lost over thirty lbs and never counted a single calorie. I ate what my body needed, and I stopped eating what was making me fat. I’ve also witness same dramatic results in anyone I know who had made the same changes to their diets.

  4. Lillian says:

    I totally agree with david.  I don’t blame the governments’ food pyramaid, I think many people are just  lazy (too lazy to cook or put the effort in to eat balanced meals, too busy to do anything but stop at the drive through after work) and self-indulgant.   I don’t even think you can blame socio-economic factors, yes its cheaper to eat lower quality, processed foods, but that doesn’t mean you must overeat on them either. Granted, I don’t think dollar menus at fast food places help the obesity situation.   People want instant gratification, they want to see results after a few workouts or after a couple of days of eating right. I see so many friends who do crash diets, lose weight fast and gain it all back as soon as eating 700 caloies a day is no longer sustainable.  People don’t want to wait six months to see a big change or commit to self-control for the rest of their lives.  Not sure what the solution is, just some observations from amongst my group of peers!

  5. Kevan Boeder says:

    I Dont disagree with the US fattening up, but I also think that the numbers are probably not as awful as what is being made out.  The gov. along with the medical industry, have been tweaking and redefining what health is, and what unhealthy is on an ongoing basis.  So, the definition of “obese” has changed since the last obesity census (for lack of a better term).  Same as what high blood pressure is.  For years normal was 120/80, but now 120/80 is pre-hypertenssive.
    Again, I have every belief that obesity is a problem and is unhealthy, and we need to do something about the trend, I just don’t think that the numbers are truly as alarming as what is being represented.

    • Ericj076 says:

      obesity numbers might not be alarming, but i think it’s pretty alarming to look at the skyrocketing rates of type II diabetes and other related diseases.

    • Pete Larson says:

      Have you been to a public pool recently? See if 1/3 or more of the
      folks there are overweight. I suspect the answer will be yes.

  6. Sarah Bland says:

    Thanks so much for posting this.  The statistics are completely alarming.  I wish our country had the willpower to choose healthy options for eating, however, a majority of people do not make the best decisions.  I think the obesity epidemic is only going to improve when our country stops being lazy when it comes to our health.

  7. I agree that obesity rates are rising.  However, I disagree with all of the recommendations of this report.  The recommendations either require more regulations or more spending (aka taxes).  People need to be held accountable for their own actions.  And parents of children need to be held accountable for their children.

    People also need to be held accountable for their own healthcare.  If obese people were to be charged for what their healthcare actually costs, they would go broke or get in better shape.  And if everyone is covered by the federal government for their healthcare, who will care about how much it costs or how obese they are?

    • Ericj076 says:

      there is very little accountability for health care now.  you can go to an emergency room any time and receive free care.  i agree that we need to figure out a way to make people more accountable for their health…because you and i are paying for their laziness already.

      i think the emphasis needs to be placed on preventing disease in the first place.  we do very little prevention.  why don’t bump it up from the current level (less than 1% of total health care spending) and see what happens.

  8. Mark U. says:

    Thanks for the link to the report. It is truly shocking that from obesity statistics the U.S. has fattened-up to such a horrific extent in a single generation!

    As noted in the report the high and growing rate of obesity will bring continued adverse health consequences including diabetes, high blood pressure, and increased strokes, cancer, and heart attacks. As a society we need to increase awareness to the severity of the problem and of the importance of an active lifestyle with sound nutrition. 

  9. Runbloggers,
    There is an evolving field called epigenetics. Humans up or down regulate genes based on environment. So if you are a human and you stop moving the body goes into store/hibernation. We are not much different then other mammals.
    Diet matters,activity matters, but it is more complex and much of it under YOUR control.
    Movement does magical things…and people like to be outside.
    As humans we can up regulate our “kill it quickly hunter” genome or our “persistance hunter” genome by how we live and exercise.  I prefer to be the persistance hunter.
    We are trying to make change here in one of the most obese states in the nation….West Virginia.  Come to Freedom’s Run and get out in the National Parks

    Dr. Mark Cucuzzella

  10. I’ve been noticing this over the past 10 years with children.  I’m just 27, and I don’t remember that many overweight kids when I was younger. It is now getting to the point that the skinny kid is the oddity.  Unfortunately, the kids are not responsible in any way for it. The majority of the blame is on the parents, but the school’s need to revamp their lunch choices as well.  Our entire culture needs to change. Kids need to get back to playing outside all day.  Parents need to stop working behind a desk for 40+ hours every week.  We need to be active as well as eat healthy.  Fortunately I think our eating trend is turning to be more healthy, but our activity levels appear to continue to decline.  Instead we are buying up all of the latest gadgets and allowing them to entertain us instead of us finding and creating our own entertainment.

  11. Alischuk says:

    I am really happy that you wrote on such an important topic because as I see it, we are facing a medical crisis that is of epidemic proportions.  Obesity and the subsequent medical complications such as Diabetes Type II are so rampant in our society today.  Simply look at your old photos from elementary school and compare them to your kids photos today and you will see that we are getting “bigger”.  As one astute writer wrote below, some of this increase in the obesity rate may be attributed to increased reporting, but I would argue that it is less than we may think.  Obesity rates have been defined by body mass index for decades and those numbers have not changed.  Unlike autism, which has become a spectrum of disorders, obesity diagnosis has not changed, therefore the numbers are real and are frightening.  
    I can not tell you how many patients we see in our clinics who are obese and suffer from diabetes.  These patients suffer from hypertension, heart disease, pulmonary disease, sleep apnea, depression, renal failure, diabetes, amputations, peripheral vascular disease…I can go on and on.  I believe that some of the blame does have to go to our emphasis on carbohydrates, but more so on processed simple carbohydrates and sugars.  Soda is a major culprit.  So is high fructose corn syrup.  Eat these foods and you will see a major insulin spike, that will drive the excess blood glucose to convert into glycogen and when those stores are saturated we store it as fat in adipose tissue.  We see obesity more so in the impoverished population because I believe that the food that are most affordable are these simple carbohydrates.  Loading up on vegetables is more expensive.  For example a red bell pepper in my local market is 4.99 per lb.  I can buy 5 boxes of mac and cheese for that price.  
    I really pray that more people become educated about this subject.  We will not be able to afford medical care for all of the individuals with these complications.  People afflicted with these diseases face major difficulties finding and keeping work, as their health problems inhibit there ability to work.  The costs of treating these problems is massive.  The cost of educating the public is miniscule in comparison.  People need to wake up and take responsibility for thier health.  I have very strong feelings about this issue and appreciate following the discussion with my favorite group of individuals, runners.

  12. No one can afford good food anymore.  Each time, which is about once a week, for my family of 5, I spend at least $300 because I want my family to eat healthy.  Produce is very expensive as well as good meats.  The cheap things are processed junk and fast food… no one thinks of food as an investment like a house or car or home/personal technology.  We need to change our ways of thinking.

  13. Scott Covington says:

    And yet…… 
    I see very little hope in stemming the tide. 

    • Pete Larson says:

      This is very disturbing…advertising more important than the health
      of our children. Disgusting.

  14. Marjoke says:

    Let me introduce myself and start by apologising for the grammar of my comment. As a dutch woman, and nurse, I’ve always been interested in the relation between food and health. As a parent or the one of the family who prepares the daily meal, you’ve got a lot of possibillities to influence the healt and wellbeing of the other members of the family. A lot of the products we find at the groceries include sugar, fat and additives that aren’t really neccesary.
    Last year we’ve visited your beautiful country and enjoyed a trip from Denver to San Franciso. The immense nature and the friendly people made it a never forgetting experience. As a chi-runner I’ve used the opportunity to run my miles in different states and landscapes.
    We’ve visited the supermarkets of the bigger cities and the small towns as well and were shocked by the amounts of sugar in a lot of the products. The bread was sweetend and we had a hard time looking for yoghurt without any sugar. In some restaurants even the salad tasted sweet.
    Now I’m a breadbaker myself and know that bread tastes wonderfull without sugar. 
    I agree with the reccomendations of Dr. Lavizzo; stimulizing people to excercise isn’t enough: make the healthier food available and affordable and show parents how they can make healthier choices.

    • I completely agree. I am Australian and have made a few longish trips to the US. In supermarkets, restaurants etc it is pretty hard to find “healthy” choices as you are surrounded by junk (which is very cheap). I found it cheaper to buy a box of donuts than a few pieces of fruit. The hotel I stayed at last time had  a “free” breakfast, however there was nothing I wanted to eat – it was donuts, a few types of cereal (all with sugar), sweetened yoghurt and toast with sweetened cream cheese or jam (which also was much sweeter than the jam we get here)   

  15. TheRunningGator says:

    Pete I just read an interesting book called “last child in the woods”. Talks about children losing touch with nature and how kids (and adults!) are being shut out of their “play” areas. Things such as developers and HOA’s are making play difficult for kids. I worry what will become the norm for my kids and their kids when it comes to exercise. I was lucky to grow up in an area (Utah) that had open space, but now that space is a highway and has about 6 major fast food chains sitting on it. Interesting thing to replace it with.

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